ABSTRACT
We report on and evaluate the process and findings of a real-time modeling exercise in response to an outbreak of measles in Lola prefecture, Guinea, in early 2015 in the wake of the Ebola crisis. Multiple statistical methods for the estimation of the size of the susceptible (i.e., unvaccinated) population were applied to weekly reported measles case data on seven subprefectures throughout Lola. Stochastic compartmental models were used to project future measles incidence in each subprefecture in both an initial and a follow-up iteration of forecasting. Measles susceptibility among 1- to 5-year-olds was estimated to be between 24% and 43% at the beginning of the outbreak. Based on this high baseline susceptibility, initial projections forecasted a large outbreak occurring over approximately 10 weeks and infecting 40 children per 1,000. Subsequent forecasts based on updated data mitigated this initial projection, but still predicted a significant outbreak. A catch-up vaccination campaign took place at the same time as this second forecast and measles cases quickly receded. Of note, case reports used to fit models changed significantly between forecast rounds. Model-based projections of both current population risk and future incidence can help in setting priorities and planning during an outbreak response. A swiftly changing situation on the ground, coupled with data uncertainties and the need to adjust standard analytical approaches to deal with sparse data, presents significant challenges. Appropriate presentation of results as planning scenarios, as well as presentations of uncertainty and two-way communication, is essential to the effective use of modeling studies in outbreak response.
Subject(s)
Disease Outbreaks , Measles/epidemiology , Adolescent , Child , Child, Preschool , Disease Susceptibility , Forecasting , Guinea/epidemiology , Humans , Infant , Measles/mortality , Measles/prevention & control , Measles Vaccine/administration & dosage , Measles Vaccine/immunology , Models, Biological , Retrospective StudiesABSTRACT
During public health crises such as the recent outbreaks of Ebola virus disease in West Africa, breakdowns in public health systems can lead to epidemics of vaccine-preventable diseases. We report here on an outbreak of measles in the prefecture of Lola, Guinea, which started in January 2015.
Subject(s)
Coinfection , Disease Outbreaks , Hemorrhagic Fever, Ebola/epidemiology , Measles/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Guinea/epidemiology , Hemorrhagic Fever, Ebola/history , History, 21st Century , Humans , Infant , Infant, Newborn , Male , Measles/history , Middle Aged , Population Surveillance , Seasons , Young AdultABSTRACT
We compared neighbouring regions of the Czech Republic (CZ) and Poland (PL) situated within 100 km of the country border, in order to compare surveillance systems performance in measuring the burden of tick-borne diseases in both countries. We used routine surveillance notifications from 1999-2008 on tick-borne encephalitis (TBE) and Lyme borreliosis (LB). We assessed the crude risk ratio (RR) across the country border, and its estimates adjusted for both population density and the expected epidemiological gradient across the region, using negative binomial regression. The crude RR between CZ and PL was 7.43 (95% Cl 6.20-8.90) for TBE, and 1.80 (1.76-1.83) for LB. The adjusted RR for TBE increased from 4.47 in 1999-2001 to 10.01 in 2005-2008, but for LB decreased from 9.30 to 2.51 during the respective periods. Those results reflect possible differences in surveillance systems performance between the two countries, as the administrative boundaries cannot constitute a barrier for zoonotic diseases and no biological processes alone can explain such large differences in disease occurrence.
Subject(s)
Encephalitis, Tick-Borne/epidemiology , Epidemiologic Research Design , Lyme Disease/epidemiology , Sentinel Surveillance , Animals , Bias , Czech Republic/epidemiology , Humans , Incidence , Poland/epidemiologyABSTRACT
With respect to the fact that acute respiratory infections (hereafter ARI) are a world-wide serious social and economic problem, more and more attention is being paid to the development and application of oral bacterial immunomodulators. The preventive effect of GS Imunostim has been evaluated during the respiratory season 2005. The study took place at 10 outpatient sites of general practitioners and lung specialists in Prague, Pilsen and Brno in the respiratory season from January to April 2005. The comparison with the ARI morbidity reports in the studied period revealed statistically significant morbidity reduction in the study participants compared to the ARI morbidity in the Czech population in the studied period from January to April 2005. The morbidity rate in the studied group was 7%, whereas ARI morbidity 15.1% was reported in the general population. The morbidity in the study group was significantly lower that in the general population.
